MEDICARE: CHELSEY CHANICE REESE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	90268	CA
2	1041C0700X	Clinical Social Worker	117606	CA

General Provider Information

NPI Number	:	1770051211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEY CHANICE REESE LCSW

Provider Business Mailing Address
First Line	:	PO BOX 712074
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90071-7074
Country	:	US
Telephone Number	:	404-788-2843
Fax Number	:

Provider Business Practice Location Address
First Line	:	2717 S ROBERTSON BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-2442
Country	:	US
Telephone Number	:	323-935-1807
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2018
Last Update Date	:	09/03/2023

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